Endometriosis is one of the most misunderstood health conditions for women. Endometriosis affects 1 in 10 women and can often be extremely debilitating. Endometriosis can occur inside the uterus and this is called adenomyosis and it can occur outside the uterus in the pelvic, abdominal or thoracic cavity. It can cause 50% of all infertility, as it can grow on, around and inside the Fallopian tubes and ovaries. It can affect a women’s daily well being due to pain and the disruption of her active lifestyle.
Physical therapy is an integral part of Endometriosis care. Physical therapy addresses the need for your active lifestyle to be restored and assists you with the appropriate skills, tools and understanding to provide you with the life you desire.
When Should I Start Physical Therapy For Endo
Physical therapy is often done before endometrial surgery and then can start as early as two weeks after endometrial surgery. Excisional surgery will remove the Endometriosis at the root of its issue. It is different from ablation surgery, as ablation merely burns the surface structures and can often cause scarring according to leading Endometriosis physicians. This is why so many women have had multiple ablation surgeries without lasting results.
Physical therapy’s intervention includes a multimodal approach due to varied health issues that might occur due to Endometriosis. Many other health issues such as Interstitial Cystitis, Irritable Bowel Syndrome, Polycystic Ovarian Syndrome, Mental health issues such as depression and anxiety.
Our six step Endometriosis Care program assists women is restoring their healthy lifestyle. This takes time, as many of our women have had endometriosis since they started their period and some even before that. A women whose mother had endometriosis is 7x’s more likely to get endometriosis herself. So this endometrial growth may have been there for a long time affecting their overall health.
Six Step Endometriosis Physical Therapy Care Program
1) Reduce Pelvic Congestion – this is bloating and pressure that can occur in the pelvic and abdominal region. The pelvic girdle contains the pelvic organs, which are the bladder, vagina, uterus ovaries, Fallopian tubes and rectum. Due to constant pain and pressure to the muscles and nerves in this region, inflammation occurs and collects and then overloads the lymph system. The lymph system removes all the waste products. There are a lot of waste byproducts in Endometriosis as there is no where for the Endometrial tissue-outside the uterus to drain, so it collects in the cavity. Ninety percent of all serotonin, our “happy juice” for the brain, is made in the gut tract. The gut tract is unhappy and the brain can then experience anxiety and depression as part of Endometriosis.
2) Release Short Tight Muscles – (this occurs often due to constant or intermittent pain) in the hips, back and pelvic floor muscles. Many people think it’s their ovaries that are painful, when really it is their muscles that are spasmed and cramped. We start many of our women with nightly propping where we have them lay on their back with their feet and pelvis up on pillows to tilt their pelvis backward for 20-30 mins every night before bed. We then teach them a diaphragmatic breathing technique because the floor is at rest when tilted up in this manner and upon inhalation of air with the breath, the floor can let go of its short tight muscles.
3) Strength – weakness often occurs in response to pain because we stop exercising and doing the activities we use to love. This is a natural response but physical therapy will educate you and teach you what is safe and how to start slowly for good results and restoration to full activities.
4) Neural Relaxation – down regulation of the peripheral nerves and the central nervous system, which is our brain is needed. This is a life long skill set all of us need to be able to handle life’s stressors. Our Autonomic Nervous System Sympathetic often gets “up regulated” or turned on too high, in response to pain and muscles that are too tight and too short. This over excitability needs to get turned down before and after surgery.
5) Mobility of Skin, Myofascial and Visceral tissue – during all of our daily movements the layers of our skin, myofascia around our muscles, nerves and vascular system, and our visceral organs in our abdominal and pelvic cavity, regardless of how many surgeries or Csections we have had, need to be free to move. These layers of tissue in Endometriosis are often scarred down and these adhesions or restrictions can cause pain patterns throughout the body. It’s like getting a snag in your sweater and it pulls at the whole garment.
The physical therapist will be trained in these hands on skills and can release and create mobility in these layers as you move.
6) Education and training – on how the bladder, bowel and sexual health can be affected due to Endometriosis. Learning skills and techniques to make these important activities happen correctly and without pain.
Come To Our Endometriosis Support Group
Endometriosis is a complex disease process and patience and a team of providers is needed as their may be other health challenges that need to be addressed as well.
At Lake City Physical Therapy we believe women with Endometriosis need a place to be taken care of, with education and resources to have a desired quality of life. Education is power and makes for a fulfilled life.
Join our Endometriosis Support Group 1 x a month.
Sheree DiBiase, PT is the owner of Lake City Physical Therapy and she and her incredible staff can help you on your journey. Hayden office (208) 762-2100, CDA (208) 667-1988, Spokane Valley (509)891-2623.